L’apport en imagerie pré opératoire par scanner et IRM cardiaque

Abstract

Stress cardiovascular magnetic resonance (CMR) allows for the detection of myocardial ischaemia with no radiation to the patient, either through the use of pharmacologic stress (adenosine, dipyridamole) first-pass perfusion cmR, or through dobutamine-atropine stress cine cmR for the assessment of abnormal segmental LV function. Stress cmR has excellent diagnostic accuracy compared to scintgraphy and echocardiography, and allows for the evaluation of location and extent of myocardial ischaemia, with obvious prognostic implications. The detection of myocardial ischaemia is part of a comprehensive cmR study, allowing for the detailed study of morphology, global and segmental LV function, and myocardial viability. Stress cmR is a very forthcoming method for the detection of myocardial ischaemia, especially in various situations for which treadmill test is doubtful, impossible, sub-maximal or when ST segment cannot be reliably assessed. On the other hand CT scan provide morphological information on native coronary artery, bypass graft but also myocardium and pericardium.